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:❑ Hypotension | :❑ Hypotension | ||
:❑ Acute myocardial infarction <br> | :❑ Acute myocardial infarction <br> | ||
</div>|C02=<div style="float: left; text-align: left; width: 25em; padding:1em;"> ❑ Administer anticoagulation therapy based on the risk of stroke, if total duration of flutter > 48 hours <br> ❑ Administer rate control therapy (AV nodal blockers) <br><br> ''THEN'' <br><br>❑ Attempt conversion | </div>|C02=<div style="float: left; text-align: left; width: 25em; padding:1em;"> ❑ Administer anticoagulation therapy based on the risk of stroke, if total duration of flutter > 48 hours <br> ❑ Administer rate control therapy (AV nodal blockers) <br><br> ''THEN'' <br><br>❑ Attempt conversion | ||
:❑ DC cardioversion | :❑ DC cardioversion | ||
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! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center; colspan="3"| {{fontcolor|#FFF|Acute management of atrial flutter}} | |||
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| style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align=center | '''Proposed therapy'''|| style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align=center | '''Recommendation''' | |||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center; colspan="3" | '''''Unstable atrial flutter''''' | |||
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''Conversion''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |▸ '''''DC cardioversion''''' | |||
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''Rate control''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |▸ '''''[[Beta blockers]]'''''<br> or <br>▸ '''''[[Verapamil]] or [[diltiazem]]'''''<br> or <br>▸ '''''[[Digitalis]]'''''<br> or <br>▸ '''''[[Amiodarone]]''''' | |||
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Revision as of 18:41, 10 March 2014
| Atrial flutter | |||||||||||||||||||||||||||||||||||||||
| Unstable | Stable | ||||||||||||||||||||||||||||||||||||||
❑ Look for the presence of any of these:
| ❑ Administer anticoagulation therapy based on the risk of stroke, if total duration of flutter > 48 hours ❑ Administer rate control therapy (AV nodal blockers) THEN ❑ Attempt conversion
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❑ Assess need for therapy to prevent recurrence | |||||||||||||||||||||||||||||||||||||||
❑ Administer antiarrythmic therapy to prevent recurrences
❑ Consider catheter ablation if antiarrhythmic therapy fails | |||||||||||||||||||||||||||||||||||||||
Anticoagulation Therapy
Shown below are tables depicting the assessment of risk of stroke and the appropriate anticoagulation therapy among patients with Atrial flutter.[1]
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| Low Risk Factors | Moderate Risk Factors | High Risk Factors |
| ▸ Female gender ▸ Age 65-74 years ▸ Coronary artery disease ▸ Thyrotoxicosis |
▸ Age ≥ 75 years ▸ Hypertension ▸ Heart failure ▸ LV ejection fraction ≤ 35% ▸ Diabetes mellitus |
▸ Previous stroke, TIA or embolism ▸ Mitral stenosis ▸ Prosthetic heart valve |
Acute management of atrial flutter
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- ↑ Fuster, V.; Rydén, LE.; Cannom, DS.; Crijns, HJ.; Curtis, AB.; Ellenbogen, KA.; Halperin, JL.; Kay, GN.; Le Huezey, JY. (2011). "2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines". Circulation. 123 (10): e269–367. doi:10.1161/CIR.0b013e318214876d. PMID 21382897. Unknown parameter
|month=ignored (help)